Active NPI
Latavia Mack
- Assistant Behavior Analyst
- Bowman, SC
National Provider Identifier
1962292367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- Practice address
- 120 Oak St
Bowman, SC 29018 - Phone
- (803) 596-8651
- NPI assigned
- May 8, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | Primary |
Addresses
Primary practice location
120 Oak St
Bowman, SC 29018
Mailing address
PO Box 485
Bowman, SC 29018-0485
Phone (803) 596-8651
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746662400000",
"number": "1962292367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 485",
"city": "BOWMAN",
"state": "SC",
"postal_code": "290180485",
"telephone_number": "803-596-8651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 OAK ST",
"city": "BOWMAN",
"state": "SC",
"postal_code": "29018",
"telephone_number": "803-596-8651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "LATAVIA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-08",
"last_updated": "2025-05-08",
"certification_date": "2025-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowman, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.